Is diet enough? The case for supplements.

by Tom Ballard, R.N., N.D.

This article was originally published in May 2008

Hand with pills

The average person currently eats only 20 varieties of food compared to more than 100 varieties consumed by our ancestors.

(May 2008) — “I eat a good diet. Do I really need a nutritional supplement?”

As a nutrition-oriented doctor, I’m asked this question continually. Many people — even my own colleagues — believe diet is enough to maintain health.

Sad to say, the evidence no longer supports diet alone for keeping us healthy. Forty years ago, when I began studying nutrition, I believed good, organic, whole food was all people needed. But the world has changed, and so has my opinion.

Certainly, I encourage my patients to eat healthy meals and snacks. Medical research overwhelmingly supports good nutrition as one of the top three actions a person can take to live a longer and healthier life. The other two are regular exercise and not smoking.

Nutrition is the bedrock on which your health is built. However, there’s compelling evidence that virtually everyone would be healthier if they supplemented their diet, even their “good diet,” with additional, concentrated nutrients.

At this point, many patients give me a questioning look. It just doesn’t make sense to many people — especially those who are conscientious about what they eat — that diet isn’t good enough to meet their needs. After all, isn’t good old-fashioned food how humans survived and thrived?

Supplements often are seen as “unnatural,” something our ancestors didn’t need, so why should we? The short answer is: We don’t live in the same world as our ancestors.

Dining with our ancestors
Everything your ancient ancestors ate was a “super food” in the sense that it was fresh, organic and relatively unprocessed. No fast food, junk food or even non-organic morsels passed their lips. Thus our genes were nourished.

Hunter-gatherers had few resources for storage and so much of what they ate was fresh off the vine, so to speak. Food begins rotting and losing nutrients the moment it is cut, picked or otherwise killed.

Today most food is trucked in from other states or even flown in from other countries. The average U.S. food travels 1,300 miles before being eaten. So, even if it started out organic and packed with nutrients, it may not be fresh by the time it enters your refrigerator, often to wait another few days before becoming dinner.

Throughout most of history people ate seasonally. No strawberries in January. When they popped a bud, sprout or flower into their mouth it was at its peak, bursting with nutrients, some of which have not been identified.

Our genetic ancestors weren’t tempted by empty calorie alternatives — they ate whole foods every day, every meal. No quick stops at the 7-11. No frivolous TV snacks. Their food processing consisted of cleaning, chopping and cooking. Later came fermentation, drying and crude grinding. Their food did not pass through milling, bleaching, extracting, canning or other modern inventions.

Another important difference between the hunter-gatherer diet and yours: Due to environmental hardships, those living in northern climates required more calories than others. What happens when greater quantities of food are consumed? You take in more protein, fat, vitamins, minerals and other micronutrients.

The modern office worker does not require as many calories, but their genes still require the same level of nutrient density. Nutrition turns genes on and off. Good nutrition, in the right amount, turns health-promoting genes on.

Skipping ahead from Hunter-Gatherers, it wasn’t until the chemical revolution of the past 100 years that people gave up eating nutrition-packed, organic, low-processed foods. In that relatively short 100 years, the majority of people moved from living a rural, farm-centered lifestyle to an urban, consumer society.

In the last 30 years, the intensity of the urbanized diet has accelerated even faster. The result: Our genes have been vaulted into a nutritional wasteland.

Recommended Dietary Allowances (RDAs)
“But,” you argue, “I’m getting my RDAs of nutrients!”

I hope you are. But the two most comprehensive studies ever conducted by the U.S. Department of Agriculture (USDA) — HANES I and II — reveal that marginal nutrient deficiencies exist in almost 50 percent of the population and that selected nutrient deficiencies exist in up to 90 percent of the population.

In addition, it’s important to remember that the RDAs are recommendations for healthy people. If you have a health problem, poor digestion or take prescription medications, you have higher requirements.

Smokers and heavy drinkers also have increased needs. Air and water pollution drain your nutrients. Those that consume sugar and simple carbohydrates need more minerals and B vitamins.

I could go on, the point being that there are a lot of odds against us consuming just RDA levels, much less optimal levels of nutrients.

Stay on top of the pyramid
The latest USDA food pyramid ( recommends a mixed diet with a variety of whole fresh foods, five to seven servings of fruits and vegetables, and regular meals. Except for no mention of organic, this sounds like our Paleolithic ancestors’ diet.

Congratulations if you’re meeting these suggestions. You’re in the minority. Up to 90 percent of the U.S. population misses at least one meal per day, usually breakfast. Barely 25 percent of the population eats 5 to 7 servings of fruits and vegetables, and the statistics would be far worse if ketchup and French fries weren’t counted as vegetables.

Also consider the research done by the USDA in 2006 showing that the nutritional content of vitamins and minerals in food has declined significantly over the past 50 years. Artificial fertilizers and breeding plants for higher yields have reduced the nutrient content of foods. Apples are bigger, yes, but not better. (See The organic advantage, February [2008] Sound Consumer.)

The USDA pyramid makes an important point by recommending “variety.” The average person currently eats only 20 varieties of food compared to more than 100 varieties consumed by our ancestors. More variety equals greater intake of nutrients, especially micronutrients.

Supplements fill a void
A “supplement” could be a daily multivitamin/mineral, the protein powder you mix for breakfast, the fish oil capsules you swallow with dinner, or that “immune booster” you take when you feel a virus knocking at your nose. Protein bars and fortified waters also increasingly are being relied upon to supplement our busy lives.

To revisit our ancestors, remember they did eat dried, extracted and otherwise concentrated foods. What is a protein bar if not the modern equivalent of Native American pemmican? I think it’s incorrect to lump all supplements into a bin marked “unnatural,” although there certainly are plenty of unhealthy supplements on the market and a bad supplement can be worse than taking nothing at all.

The scientific literature on supplements
It’s a mixed bag. The evidence for consuming a multivitamin is strong — so strong that even the conservative American Medical Association endorses their use.

Single vitamins, on the other hand, have not done as well. A number of studies have shown negative results. Extrapolating useful information from these studies is difficult because synthetic, incomplete forms of vitamins often are used and the studies are poorly designed (dosages are too low or too high).

I caution patients against self-prescribing single vitamins or minerals. Anyone taking a prescription drug should consult a nutrition expert to counter-balance any negative impacts.

Fiber commonly is deficient in industrial diets and is known to decrease cholesterol, the risk of diabetes and colon cancer, among other health benefits.

Omega-3 oil intake has declined in our diet and is known to decrease inflammation and heart disease while improving mood and memory. Probiotics, the “good bacteria” critical for healthy gut function, often are low due to antibiotics (including those given to domestic animals), excess sugar and stress.

Determining your need for supplements
Your supplemental need is best answered by analyzing your diet and lifestyle. The ideal way to do this is to keep a diet diary for a month, then calculate your daily intake of macronutrients (protein, carbohydrates and fats), micronutrients (vitamins, minerals, antioxidants), and other food factors.

Seek the services of a nutrition-oriented practitioner. If you live in a polluted environment or if your job places you in harm’s way, you want your body-burden of toxins measured.

Just how good is your diet?
Hunter-gatherers set the bar very high. To match the past you must be eating large amounts of 100 percent organic, fresh, unprocessed foods, never miss a meal, and every day eat 5 to 7 servings of fruits and vegetables. Oh, and live in a pollution-free environment.

As hard as you try, it’s unlikely you’ll ever match the quality of your ancestors’ diet or environment. Quality supplements offer a viable way of ensuring your genes are nurtured with high-density nutrition.

Tom Ballard, R.N., N.D., is founder of Pure Wellness Centers “green medicine; finding the cause, providing natural solutions.” Visit or 425-255-8100, ext. 6, or 206-324-2225.

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Here’s something that chemical companies and industrial agribusiness don’t want you to know: An analysis of nearly 100 peer-reviewed studies concludes, yes, there is sufficient quality research to confirm the nutritional superiority of plant-based organic foods.

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